Atripla's sides effects

Jan 1, 2011

My CD4 count was getting below 500 and I've been experiencing other synthoms like pain in my fingers and arms and fatigue that my Dr says could improve if I start HIV treatment. I started on Atripla 10 days ago, with vivid dreams and some insommia since the first night.
On day 9 I started getting skin rash on my chest, and hands. My Doctor saw me right away yesterday and said it was a mild rash and prescribed Benadryl twice a day. Last night was a hell of night with the itching and even panic attack due to this. This morning I noticed the rash expanded to my torso, weist, abs, tights, neck and even my palm. My question is it could get worse? My Dr says it should go away in a couple of weeks.Im getting desperate with the itching, also thinking how to handle once I get back to work after the holidays. thanks.

Response from Dr. Henry

Most likely you are having a particularly severe skin rash from the efavirenz in Atripla. Though it is unusual for rashes to be life threatening or require stopping the efavirenz (switching off Atripla) it does happen and requires good clinical diligence. Since the majority of patients who experience the problems you are having go on to do well and have a favorable view of Atripla, it often is up to the patient whether they can tolerate an initial rough patch (usually lasting 2-4 weeks). A boosted protease inhibitor or raltegravir are often considered as alternatives to efavirenz. Good luck. KH

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